Air rescue for pediatric trauma in a metropolitan region of brazil: Profiles, outcomes, and overtriage rates

Abstract text (incl. references and figure legends)

Introduction: Helicopter rescue involves risks to staff and patients and has higher operational costs. Studying prehospital triage criteria, overtriage and outcomes could improve its use, providing better management of costs and risks. Our objective was to determine the epidemiologic profile and evaluate outcomes and overtriage rates of trauma victims aged <18 years old (yo) rescued by helicopter in a Brazilian Metropolitan Area. Methods: Observational, retrospective study of 49 medical records from victims of trauma aged <18 yo rescued by helicopter and transferred to a University Hospital. Results: 79.6% of the patients were male, with mean age of 11.3 yo. 30.6% of the traumas are due to vehicular collisions, and traumatic brain injuries occurred in 57.1%. A total of 59.1% patients had severe trauma (Injury Severity Score; ISS >15), and 69.4% required admission to the intensive care unit. Overtriage varied from 18.4 to 40.8% depending on the criteria used, being more frequent in individuals between 1 and 5 yo. Death occurred in 20.4% patients. On prehospital evaluation, 90.6% of the patients presented severe trauma according to the Pediatric Trauma Score (PTS ≤8) and 72% according to the Revised Trauma Score (RTS ≤11). Of these, 24.1% and 33.3%, respectively, have ISS <15. None of the patients with PTS >8 and 42.8% of those with RTS >11 have ISS >15. Conclusion: Air rescue of pediatric trauma victims was used mainly for critically ill individuals, resulting in overtriage rates similar with that found in the literature. PTS showed the lowest rates of overtriage within excellent rates of undertriage. References: 1-Moront ML, et al. Helicopter transport of injured children: system effectiveness and triage criteria. J Pediatr Surg. (1996). 2-Mora MC, et al. Pediatric trauma triage: a pediatric trauma society research committee systematic review. J Trauma Acute Care Surg. (2020). 3-Michailidou M, et al. Helicopter overtriage in pediatric trauma. J Pediatr Surg. (2014).

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